Spine
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Comparative Study
Prediction of spinal canal expansion following cervical laminoplasty: a computer-simulated comparison between single and double-door techniques.
Laminoplasty was simulated using a computer-assisted technique to assess the amount of canal expansion. ⋯ Our investigation provides insight into canal expansion after laminoplasty. The increased amount of canal following laminoplasty can be predicted by the regression equations. This may allow preoperative determination of the optimal size of the opening needed to establish adequate canal space for the spinal cord. Both single and double-door techniques of laminoplasty provide sufficient room for posterior migration of the spinal cord, although gaining different canal expansion.
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Multicenter Study Clinical Trial
Heterotopic ossification in total cervical artificial disc replacement.
Prospective clinical study enrolled in 2 centers (Munich and Liberec) as part of a prospective European multicenter study with ProDisc C (Synthes Inc., Paoli, PA). ⋯ Only 33.8% of the patients did not show any signs of heterotopic ossification, and the rate of spontaneous fusion after TCDR 1 year after surgery was unexpectedly high. There were 49.4% of the patients with grade 2-3 ossification, which lets us suspect an even higher rate of spontaneous fusion after long-term follow-ups. Motion preservation after TCDR is only guaranteed if spontaneous fusion can be prevented. Thus, mobility of the implanted segments needs to be further studied.
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Randomized Controlled Trial Comparative Study
The treatment of disc-herniation-induced sciatica with infliximab: one-year follow-up results of FIRST II, a randomized controlled trial.
A randomized controlled trial. ⋯ Although the long-term results of this randomized trial do not support the use of infliximab compared with placebo for lumbar radicular pain in patients with disc herniation-induced sciatica, further study in a subgroup of patients with L4-L5 or L3-L4 herniations, especially in the presence of Modic changes, appears to be warranted.
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Randomized Controlled Trial
Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases.
A prospective randomized study involving 280 consecutive cases of lumbar disc herniation managed either by an endoscopic discectomy alone or an endoscopic discectomy combined with an intradiscal injection of a low dose (1000 U) of chymopapain. ⋯ A high percentage of patient satisfaction could be obtained with a posterior lateral endoscopic discectomy for lumbar disc herniation, and a statistically significant improvement of the results was obtained when an intradiscal injection of 1000 U of chymopapain was added. There was a low recurrence rate with no major complications. The method can be applied in any type of lumbar disc herniation, including the L5-S1 level.
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Comparative Study
The effect of lumbar flexion and extension on disc contour abnormality measured quantitatively on magnetic resonance imaging.
Experimental study with subjects as their own control. ⋯ Spine position should be standardized when assessing disc contour abnormality with MRI. The largest measured disc contour abnormalities when lying supine in a standard MR scanner are observed in the neutral position, as opposed to flexion or extension.